Thursday, May 02, 2013

Proposed Rule Updates SNF PPS Payment Rates for FY 2014

The Centers for Medicare and Medicaid Services (CMS) released a proposed rule yesterday that outlines Fiscal Year (FY) 2014 updates for Skilled Nursing Facility (SNF) prospective payment system (PPS) payment rates. The updates included a 1.4% estimated SNF market basket update to FY 2014 payments, with CMS estimating a $500 million increase in FY 2014 aggregate payments. CMS also noted that providers were not negatively impacted by FY 2012 allocation of group therapy minutes and implementation of the change of therapy.

Additionally, the proposed rule would add items 00420 (Calendar Days of Therapy) to the Minimum Data Set and clarify that "classification criteria for the Rehabilitation RUG categories require that the resident receive the requisite number of distinct calendar days of therapy to be classified into the Rehabilitation RUG category." RUG stands for resource utilization group. The RUG level, which is based on facility needs, nursing care, and therapy minutes provided per week, determines the amount of money per day that Medicare will pay for a patient's stay at a facility.

The proposed rule would also invite suggestions to identify alternatives to current methods used to pay for therapy services under the SNF PPS, and require SNFs, beginning October 1, 2013, to record the number of distinct calendar days of therapy provided by all rehabilitation disciplines over the 7-day look-back period for the current assessment.

CMS will accept comments on provisions of the proposed rule until July 1, 2013. APTA will provide a comprehensive summary of the proposed rule in the next few days and will submit comments on behalf of the membership.